Topics Related to Medicaid Direct

Prior Authorizations End-dated When a Beneficiary Transitions to Managed Care

NC Medicaid Direct PA effective begin and end dates will be modified to align with the individual’s eligibility segment.

Outpatient Specialized Therapies Prior Authorization (PA) Update

A new PA is required for beneficiaries returning to NC Medicaid Direct.

New Billing Codes for Social Drivers of Health

New billable codes available Sept.1 to address social drivers of health

Non-Emergency Medicaid Transportation Updates - April 29

WellCare broker update, contracting with transportation brokers, emergent care reminder

Provider Education Webinar: Understanding Your Responsibilities to the Payment Error Rate Measurement (PERM) Program

CMS PERM audit educational provider webinar to be held in April 2022

Charter Schools Eligible for Medicaid Reimbursement

Charter schools, as Local Education Agencies, are to participate in North Carolina Medicaid reimbursement.

Fact Sheets Available for Children and Youth Transitioning to Foster Care

Fact sheets that address questions related to the Standard Plan disenrollment process for children in foster care are now available.

NC Medicaid Managed Care Provider Update – Dec. 21, 2021

Key dates, Playbook updates, Medicaid Direct, fabrication of eyeglasses, managed care eligibility for newborns, prior authorization, FAQs, Provider Ombudsman, Provider directory, PHP quick reference guides and help center.

NC Medicaid Managed Care Provider Update – Oct. 29, 2021

Upcoming Key Milestone Dates, Playbook Updates, Request to Move to NC Medicaid Direct Process, Prior Authorizations, Frequently Asked Questions, Contracting Reminders, Ombudsman and Webinars

Administration of Long Acting Injectable Medications

Effective Oct. 1, 2021, immunizing pharmacists are authorized to administer Long Acting Injectable (LAI) medications.